Why does billirubin increase in intravascular haemolysis?

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In intravascular hemolysis, red blood cells break down, releasing hemoglobin that binds to haptoglobin and is transported to the liver. The liver processes this hemoglobin, breaking it down into heme and globin, with heme being converted to biliverdin and then to bilirubin. Bilirubin is then transported to the liver for conjugation. However, during hemolysis, the rate of bilirubin production exceeds its conjugation and excretion, leading to hyperbilirubinemia. This results in increased bilirubin levels in the bloodstream.
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Hello everyone,

Ok so red blood cells break and release haemoglobin. Now I checked a book and it all it showed is that this haemoglobin binds to haptoglobin and goes to liver. Now billirubin is made by reticulocytes in spleen using haem. So does liver break this haemoglobin haptoglobin complex, and release haem into the circulation, so reticulocytes in spleen can act on it or does this haemoglobin travel to spleen? Thanks :smile:
 
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sameeralord said:
Hello everyone,

Ok so red blood cells break and release haemoglobin. Now I checked a book and it all it showed is that this haemoglobin binds to haptoglobin and goes to liver. Now billirubin is made by reticulocytes in spleen using haem. So does liver break this haemoglobin haptoglobin complex, and release haem into the circulation, so reticulocytes in spleen can act on it or does this haemoglobin travel to spleen? Thanks :smile:

Hb is broken down to haem and globin which is converted to biliverdin and then to bilirubin.

Bilirubin is transported to the liver where it is conjugated.

In hemolysis , the production of bilirubin outstrips its conjugation and removal through excretion. Hence the hyberbilirubinemia.
 
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